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lvhugrn
PICC usage
Do any hospitals have a policy in place for PICCs to be used pending CXR in much the same manner as ET tubes?
Wendy Erickson RN
We never use a PICC without
We never use a PICC without having xray confirmation of adequate placement.  We are able to obtain a stat CXR and results are available within minutes.

Wendy Erickson RN
Eau Claire WI

lynncrni
You must know where the tip
You must know where the tip is located for any central venous catheter before it is used for any infusion or injection. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

rivka livni
You must know where the tip

You must know where the tip is prior to use.

To illustrate this, I placed a R side PICC that had no problems what so ever during placement, CXR was a little abnormal but a number of radiologists could not tell where the tip or catheter really were, even after we did a latteral view, it looked ALMOST as if it was in the SVC w/ tip in the CavoAtrial junction. IR Docs said for me to bring the patient down, they injected contrast only to find out it was all the way deep into the R thoracic vein, which in that patient was almost excatly paralel but about 1 cm "off" to right of the SVC.

From seeing the contrast flow, we could tell that the PICC was sitting very tightly in the thoracic vein, had it been used for TPN or Vanco, I don't want to think what kind of damage that would have created.

Untill you are 100% sure where the tip is, after insertion, you should not use it.

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